Does plasma leptin concentration predict the nutritional status of hemodialyzed patients with chronic renal failure?
Jerzy Chudek, Marcin Adamczak, Magdalena Kania, Aleksandra Hołowiecka, Wioletta Rozmus, Franciszek Kokot, Andrzej Więcek
Med Sci Monit 2003; 9(8): CR377-382
BACKGROUND: Patients with chronic renal failure are characterized by hyperleptinemia, and leptin is presumed to be an anorectogenic hormone. The aim of this prospective study was to analyze changes in body composition and parameters of nutritional status in relation to changes in plasma leptin concentration in uremic patients during the first year of hemodialysis therapy. MATERIAL/METHODS: 21 patients (10 F, 11 M, mean age 51+/- 3 years, BMI 24.3+/-1.1 kg/m2) were enrolled in this study. Nutritional status was evaluated by anthropometric parameters, estimation of body composition (DEXA method), and biochemical markers (plasma concentrations of albumin, cholesterol, triglycerides, transferrin) and plasma leptin concentration. Tests were performed twice: immediately after initiation of hemodialysis therapy and again 12 months later. RESULTS: After 12 months of hemodialysis therapy, the changes in body mass (-2.6+/-0.8 kg; p=0.23), total fat mass (TFM) (-0.3+/-0.8 kg; p=0.68) and total lean mass (TLM) (+0.5+/-0.8 kg; p=0.26) were insignificant. Plasma leptin concentration and estimated biochemical nutritional parameters did not change markedly. A significant positive correlation was noticed between TFM and plasma leptin concentration (R=0.521; p=0.02) at the beginning of hemodialysis therapy and between changes in TFM and plasma leptin concentration (R=0.466; p=0.04) after one year. CONCLUSIONS: Plasma leptin concentration does not predict forthcoming changes in body composition and changes of nutritional status in uremic patients after the first year of hemodialysis.
Keywords: Body Composition, Body Mass Index, C-Reactive Protein - metabolism, Female, Humans, Kidney Failure, Chronic - blood, Kidney Failure, Chronic - therapy, Leptin - blood, Male, Middle Aged, Nutritional Status, Predictive Value of Tests, Renal Dialysis, Statistics, Uremia - blood, Uremia - therapy